A comparison of humidified and unconditioned gases in the delivery room for stabilising preterm infants less than 30 weeks gestation at birth

INTERVENTION: Infants under 30 weeks gestation who require respiratory support at birth will receive positive pressure delivered by gases (oxygen and air) that are heated and humidified using a heated humidifier unit. Infants requiring ongoing respiratory support will continue to receive heated and humidified gases during transport to the neonatal intensive and special care unit (NISC). The intervention will be given for the duration of the stabilisation in the delivery room and transport from the delivery room to the NISC. This will differ on a case by case basis and be directed by the attending clinican. CONDITION: Prematurity PRIMARY OUTCOME: Rectal temperature measured with a Nexcare digital thermometer on admission to the neonatal intensive and special care unit. SECONDARY OUTCOME: All cause mortality before discharge from hospital. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Associated morbidities: a) hypotension requiring inotrope support; b) patent ductus arteriosus requiring treatment; ; c) Ultrasound evidence of brain injury: Grade 3 or 4 intraventricular haemorrhage and Periventricular Leucomalacia. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Highest inspired oxygen requirement within the first 24 hours following admission to the neonatal intensive and special care unit. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Incidence of air leaks diagnosed clinically or on radiological examination. This outcome will be assessed from patient data recorded in the medical records and nursing charts and reports of radiological examinations. Incidence of bronchopulmonary dysplasia defined as requirement for respiratory support and/or oxygen at 36 weeks corrected gestation. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Intubation in the first 24 hours. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Length of hospital stay (combined duration of stay in level 1, 2 and 3 units) ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Requirement for surfactant replacement. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Total duration in days of respiratory support including ventilation via an endotrachael tube, nasal continuous positive airway pressure, high flow nasal cannulae and low flow oxygen. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. Worst blood gas pH in the first 24 hours. ; This outcome will be assessed from patient data recorded in the medical records and nursing charts. INCLUSION CRITERIA: Preterm infants less than 30 weeks gestation born in the participating centres